Monty C. Wilson, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

47339 Issued in CA

Practice address

1122 E Lincoln Ave
Ste. 105
Orange, CA 92865-1907

Phone

(714) 998-7450

Fax

(714) 998-2857

NPI assigned

Nov 15, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Oral Surgery

Education

University of Oklahoma College of Dentistry, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sanford L Ratner DDS and Monty C Wilson DDS IncGroup PAC ID 1850479858, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sanford L. Ratner DDS and Monty C.Wilson DDS Inc.

  • Oral and Maxillofacial Surgery (Dentist)
  • Santa Ana, CA
  • NPI 1154514388
  Medicare reassignment Care Compare group NPD
• St. Joseph Health Northern California, LLC

  • General Acute Care Hospital
  • Eureka, CA
  • NPI 1609858950
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487726055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 E LINCOLN AVE",
            "address_2": "STE. 105",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928651907",
            "telephone_number": "714-998-7450",
            "fax_number": "714-998-2857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 E LINCOLN AVE",
            "address_2": "STE. 105",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928651907",
            "telephone_number": "714-998-7450",
            "fax_number": "714-998-2857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MONTY",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "47339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyla Wilson, LCSW
• Laura Ann Wilson
• Leah Marie Wilson, N.P.
• Lisa Marie Wilson, IMF/MFT
• Monet Alisha Wilson
• Natalie Wilson, N.P.
• Roger Wilson, MD
• Samuel Eric Wilson, MD
• Seon Wilson
• Skylar B Wilson

• Oral and Maxillofacial Surgery (Dentist) in Orange, CA
• Providers in Orange, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.